Verify Azathioprine

Drug JSON

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{
  "slug": "azathioprine",
  "nameEn": "Azathioprine",
  "nameTh": "อะซาไทโอพรีน",
  "class": "Immunosuppressant — purine antimetabolite (canine; ⚠️ toxic in cats)",
  "mechanism": "ยากดภูมิคุ้มกันกลุ่ม purine antimetabolite ยับยั้งการสร้าง DNA ของ lymphocyte ที่กำลังแบ่งตัว ลดการตอบสนองภูมิคุ้มกัน; ใช้เป็น steroid-sparing agent ในโรคภูมิคุ้มกัน",
  "brandNamesTh": [
    "Imuran"
  ],
  "indications": [
    {
      "text": "โรคภูมิคุ้มกันทำลายตนเองในสุนัข (IMHA, IMPA, IBD, pemphigus) เป็น steroid-sparing agent ออกฤทธิ์ช้า (3–5 สัปดาห์)",
      "cites": [
        "merck-immuno",
        "vca-azathioprine"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "⚠️ ห้าม/หลีกเลี่ยงในแมว — แมวขาดเอนไซม์ thiopurine methyltransferase (TPMT) จึงเกิด bone marrow suppression รุนแรงถึงตาย; ในสุนัขระวังตับเป็นพิษและกดไขกระดูก",
      "cites": [
        "merck-immuno",
        "vca-azathioprine"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "กดไขกระดูก (โดยเฉพาะ Giant Schnauzer ไวเป็นพิเศษ), ตับเป็นพิษ, GI upset, ตับอ่อนอักเสบ; ⚠️ แมว = myelosuppression ร้ายแรง",
      "cites": [
        "merck-immuno"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Immune-mediated disease (steroid-sparing)",
      "route": "PO",
      "dose": "2 mg/kg PO วันละครั้งช่วงแรก แล้วลดเป็นวันเว้นวัน",
      "cites": [
        "merck-immuno",
        "vca-azathioprine"
      ]
    },
    {
      "species": "feline",
      "indication": "Generally AVOIDED",
      "route": "PO",
      "dose": "⚠️ หลีกเลี่ยงในแมว; หากจำเป็นจริง 0.3 mg/kg วันเว้นวัน ภายใต้การติดตามใกล้ชิด",
      "cites": [
        "merck-immuno",
        "vca-azathioprine"
      ]
    }
  ],
  "monitoring": [
    {
      "text": "ตรวจ CBC (เฝ้าระวัง cytopenia) และค่าตับเป็นระยะ — ทุก 1–2 สัปดาห์ช่วงแรก แล้วทุก 1–3 เดือน",
      "cites": [
        "merck-immuno"
      ]
    }
  ],
  "citations": [
    {
      "id": "merck-immuno",
      "type": "textbook",
      "title": "Immunosuppressive and Immunomodulatory Drugs — MSD/Merck Veterinary Manual",
      "year": 2025,
      "url": "https://www.merckvetmanual.com/pharmacology/immune-system-pharmacology/immunosuppressive-and-immunomodulatory-drugs-used-in-animals",
      "note": "Authoritative veterinary pharmacology reference. Copyrighted, cited not mirrored.",
      "cid": null
    },
    {
      "id": "vca-azathioprine",
      "type": "monograph",
      "title": "Azathioprine — VCA Animal Hospitals",
      "year": 2025,
      "url": "https://vcahospitals.com/know-your-pet/azathioprine",
      "note": "Clinical drug-library reference.",
      "cid": null
    },
    {
      "id": "wikipedia-azathioprine",
      "type": "monograph",
      "title": "Azathioprine — Wikipedia",
      "year": 2026,
      "url": "https://en.wikipedia.org/wiki/Azathioprine",
      "note": "Tertiary cross-check for class + mechanism. CC BY-SA 4.0. Not sole authority.",
      "cid": null
    }
  ],
  "mirroredFrom": [
    {
      "id": "who-atc",
      "name": "WHO ATC/DDD Index",
      "url": "https://www.whocc.no/atc_ddd_index/",
      "asOfDate": "2026-05-30",
      "license": "WHO publication, free for use with attribution"
    }
  ],
  "mirrorCIDs": [],
  "codes": {
    "atc": {
      "code": "L04AX01",
      "name": "Azathioprine",
      "level": 5
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-30",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-30",
  "version": 1,
  "changelog": [
    {
      "version": 1,
      "date": "2026-05-30",
      "summary": "New entry — clinical content compiled from cited authoritative sources (Merck Veterinary Manual / VCA / VSSO chemo protocols / FDA-EMA labels / Today's Vet Practice), cross-checked. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ]
}

Public keys used

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